| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,442 |
12,336 |
$4.08M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,374 |
8,266 |
$2.81M |
| 90834 |
Psychotherapy, 45 minutes with patient |
12,047 |
5,973 |
$2.70M |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,835 |
2,706 |
$1.50M |
| X5622 |
|
3,225 |
2,765 |
$800K |
| D0120 |
Periodic oral evaluation - established patient |
2,832 |
2,768 |
$691K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,708 |
2,635 |
$640K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,843 |
967 |
$555K |
| D0140 |
Limited oral evaluation - problem focused |
2,020 |
1,944 |
$402K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,021 |
958 |
$325K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
940 |
743 |
$175K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
976 |
678 |
$137K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
8,022 |
7,753 |
$91K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
728 |
617 |
$61K |
| D1110 |
Prophylaxis - adult |
1,562 |
1,528 |
$58K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
549 |
420 |
$51K |
| 90791 |
Psychiatric diagnostic evaluation |
138 |
122 |
$44K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
388 |
309 |
$43K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
197 |
82 |
$37K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
112 |
105 |
$33K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
87 |
75 |
$30K |
| 99215 |
Prolong outpt/office vis |
159 |
150 |
$28K |
| D1206 |
Topical application of fluoride varnish |
2,359 |
2,279 |
$22K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
535 |
485 |
$16K |
| D1120 |
Prophylaxis - child |
621 |
611 |
$15K |
| D5899 |
|
63 |
47 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
56 |
51 |
$7K |
| D7140 |
Extraction, erupted tooth or exposed root |
41 |
25 |
$6K |
| 99188 |
|
1,313 |
1,055 |
$5K |
| 96156 |
|
59 |
48 |
$4K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
54 |
42 |
$1K |
| D2940 |
|
34 |
26 |
$1K |
| 91322 |
|
90 |
84 |
$874.81 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,780 |
4,104 |
$556.90 |
| D0274 |
Bitewings - four radiographic images |
4,724 |
4,590 |
$499.46 |
| 36415 |
Collection of venous blood by venipuncture |
7,659 |
6,819 |
$432.36 |
| D0220 |
Intraoral - periapical first radiographic image |
1,841 |
1,749 |
$431.62 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,285 |
2,123 |
$401.11 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,107 |
2,870 |
$287.18 |
| D0330 |
Panoramic radiographic image |
2,747 |
2,665 |
$216.26 |
| 80061 |
Lipid panel |
612 |
537 |
$144.05 |
| 80053 |
Comprehensive metabolic panel |
93 |
86 |
$95.29 |
| 90480 |
|
198 |
158 |
$78.40 |
| 0011A |
|
157 |
151 |
$67.76 |
| 85027 |
|
410 |
345 |
$63.66 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
40 |
38 |
$51.31 |
| 81001 |
|
613 |
574 |
$40.55 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
178 |
173 |
$32.00 |
| 90656 |
|
187 |
141 |
$23.00 |
| 90686 |
|
1,401 |
1,219 |
$18.73 |
| 82043 |
|
97 |
92 |
$17.19 |
| 82570 |
|
97 |
92 |
$15.40 |
| D0230 |
Intraoral - periapical each additional radiographic image |
64 |
37 |
$12.78 |
| 36416 |
|
150 |
129 |
$3.00 |
| 92551 |
|
2,282 |
1,915 |
$0.00 |
| 96150 |
|
123 |
85 |
$0.00 |
| 96127 |
|
335 |
277 |
$0.00 |
| 90688 |
|
476 |
399 |
$0.00 |
| 90657 |
|
91 |
86 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
576 |
490 |
$0.00 |
| 0012A |
|
98 |
94 |
$0.00 |
| 91301 |
|
397 |
369 |
$0.00 |
| D1330 |
|
534 |
509 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
14 |
12 |
$0.00 |
| D1310 |
|
303 |
285 |
$0.00 |
| 90651 |
|
213 |
175 |
$0.00 |
| 90619 |
|
35 |
24 |
$0.00 |
| 87070 |
|
32 |
32 |
$0.00 |
| 90723 |
|
32 |
27 |
$0.00 |
| D0603 |
|
116 |
115 |
$0.00 |
| 90647 |
|
29 |
24 |
$0.00 |
| D0602 |
|
64 |
64 |
$0.00 |
| D0601 |
|
61 |
51 |
$0.00 |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
37 |
37 |
$0.00 |
| D1351 |
Sealant - per tooth |
247 |
43 |
$0.00 |
| 90696 |
|
21 |
13 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
16 |
15 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
13 |
13 |
$0.00 |
| 90785 |
|
7,309 |
2,743 |
$0.00 |
| 99173 |
|
2,305 |
1,932 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,774 |
1,465 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
366 |
318 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
428 |
282 |
$0.00 |
| 87210 |
|
345 |
330 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
158 |
151 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
150 |
148 |
$0.00 |
| 90670 |
|
125 |
90 |
$0.00 |
| 81025 |
|
446 |
413 |
$0.00 |
| 90710 |
|
71 |
51 |
$0.00 |
| 91321 |
|
23 |
17 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
66 |
63 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
321 |
279 |
$0.00 |
| D9110 |
|
16 |
16 |
$0.00 |
| 90633 |
|
46 |
39 |
$0.00 |
| 90461 |
|
196 |
130 |
$0.00 |
| 90715 |
|
52 |
39 |
$0.00 |
| 83655 |
|
12 |
12 |
$0.00 |
| 90734 |
|
32 |
32 |
$0.00 |
| 80305 |
|
47 |
32 |
$0.00 |
| 81003 |
|
17 |
17 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
20 |
12 |
$0.00 |